NUR 504
EXAM 4
Advanced Health Assessment
Questions And Answers Plus Rationales
Instant Pdf Download | 2026
THIS DOCUMENT CONTAINS :
➢ Printable + Tablet-friendly Pdf
➢ Latest Qs & Ans 2026/27 Update
➢ Qs & Answers Plus Rationales
,1. A 62-year-old male with a 40-pack-year smoking history presents
with new-onset hemoptysis, weight loss, and a persistent cough. On
exam, you note a fixed, firm, non-tender left supraclavicular lymph
node. The most appropriate next step is:
a) Chest X-ray
b) CT chest with contrast
c) Fine-needle aspiration of the node
d) Bronchoscopy
Answer: c (Virchow’s node in a smoker with pulmonary symptoms
strongly suggests metastatic lung cancer; tissue diagnosis is a priority.
FNA of the node is least invasive and often diagnostic.)
2. A 28-year-old female presents with episodic palpitations, chest
discomfort, and anxiety. During an episode, you auscultate a mid-
systolic click followed by a late systolic murmur at the apex. Which
maneuver would make the murmur longer and louder?
a) Squatting
b) Handgrip
c) Standing
d) Leg raise
Answer: c (Standing decreases preload, causing the mitral valve prolapse
to occur earlier and the murmur to become longer and louder. Squatting
increases preload and delays the click/murmur.)
,3. A 45-year-old male with a history of alcohol use disorder presents
with acute-onset severe epigastric pain radiating to the back,
nausea, and vomiting. On exam, he has epigastric tenderness and
hypoactive bowel sounds. Serum lipase is 950 U/L. The most likely
diagnosis is:
a) Acute cholecystitis
b) Acute pancreatitis
c) Perforated peptic ulcer
d) Acute mesenteric ischemia
Answer: b (Acute pancreatitis: epigastric pain radiating to back, lipase
>3x upper limit of normal. Alcohol is a common cause.)
4. A 72-year-old female reports progressive difficulty with memory,
apathy, and urinary incontinence. Her gait is magnetic (feet seem
stuck to the floor). The most likely diagnosis is:
a) Alzheimer’s disease
b) Normal pressure hydrocephalus (NPH)
c) Parkinson’s disease
d) Vascular dementia
Answer: b (Classic triad of NPH: cognitive impairment, gait apraxia
(magnetic), urinary incontinence. MRI shows ventriculomegaly.)
5. When performing a pediatric well-child exam on a 6-month-old
infant, which primitive reflex should have already disappeared?
a) Moro reflex
, b) Palmar grasp
c) Tonic neck (asymmetric tonic neck reflex)
d) All of the above
Answer: d (Moro disappears by 4-6 months; palmar grasp by 4-6
months; tonic neck by 6-7 months. By 6 months, these should be absent
or fading.)
6. A 55-year-old female presents with a 6-month history of bilateral
hand pain, stiffness, and swelling that is worse in the morning
lasting >1 hour. On exam, she has symmetric swelling of the MCP
and PIP joints. The most likely diagnosis is:
a) Osteoarthritis
b) Rheumatoid arthritis
c) Gout
d) Psoriatic arthritis
Answer: b (RA: symmetric small joint involvement, morning stiffness >1
hour, systemic symptoms.)
7. On fundoscopic exam of a patient with long-standing
hypertension, you see “cotton-wool spots” and “flame-shaped
hemorrhages” with sharp optic disc margins. This represents:
a) Hypertensive retinopathy (Grade III)
b) Diabetic retinopathy
c) Papilledema
d) Central retinal vein occlusion
EXAM 4
Advanced Health Assessment
Questions And Answers Plus Rationales
Instant Pdf Download | 2026
THIS DOCUMENT CONTAINS :
➢ Printable + Tablet-friendly Pdf
➢ Latest Qs & Ans 2026/27 Update
➢ Qs & Answers Plus Rationales
,1. A 62-year-old male with a 40-pack-year smoking history presents
with new-onset hemoptysis, weight loss, and a persistent cough. On
exam, you note a fixed, firm, non-tender left supraclavicular lymph
node. The most appropriate next step is:
a) Chest X-ray
b) CT chest with contrast
c) Fine-needle aspiration of the node
d) Bronchoscopy
Answer: c (Virchow’s node in a smoker with pulmonary symptoms
strongly suggests metastatic lung cancer; tissue diagnosis is a priority.
FNA of the node is least invasive and often diagnostic.)
2. A 28-year-old female presents with episodic palpitations, chest
discomfort, and anxiety. During an episode, you auscultate a mid-
systolic click followed by a late systolic murmur at the apex. Which
maneuver would make the murmur longer and louder?
a) Squatting
b) Handgrip
c) Standing
d) Leg raise
Answer: c (Standing decreases preload, causing the mitral valve prolapse
to occur earlier and the murmur to become longer and louder. Squatting
increases preload and delays the click/murmur.)
,3. A 45-year-old male with a history of alcohol use disorder presents
with acute-onset severe epigastric pain radiating to the back,
nausea, and vomiting. On exam, he has epigastric tenderness and
hypoactive bowel sounds. Serum lipase is 950 U/L. The most likely
diagnosis is:
a) Acute cholecystitis
b) Acute pancreatitis
c) Perforated peptic ulcer
d) Acute mesenteric ischemia
Answer: b (Acute pancreatitis: epigastric pain radiating to back, lipase
>3x upper limit of normal. Alcohol is a common cause.)
4. A 72-year-old female reports progressive difficulty with memory,
apathy, and urinary incontinence. Her gait is magnetic (feet seem
stuck to the floor). The most likely diagnosis is:
a) Alzheimer’s disease
b) Normal pressure hydrocephalus (NPH)
c) Parkinson’s disease
d) Vascular dementia
Answer: b (Classic triad of NPH: cognitive impairment, gait apraxia
(magnetic), urinary incontinence. MRI shows ventriculomegaly.)
5. When performing a pediatric well-child exam on a 6-month-old
infant, which primitive reflex should have already disappeared?
a) Moro reflex
, b) Palmar grasp
c) Tonic neck (asymmetric tonic neck reflex)
d) All of the above
Answer: d (Moro disappears by 4-6 months; palmar grasp by 4-6
months; tonic neck by 6-7 months. By 6 months, these should be absent
or fading.)
6. A 55-year-old female presents with a 6-month history of bilateral
hand pain, stiffness, and swelling that is worse in the morning
lasting >1 hour. On exam, she has symmetric swelling of the MCP
and PIP joints. The most likely diagnosis is:
a) Osteoarthritis
b) Rheumatoid arthritis
c) Gout
d) Psoriatic arthritis
Answer: b (RA: symmetric small joint involvement, morning stiffness >1
hour, systemic symptoms.)
7. On fundoscopic exam of a patient with long-standing
hypertension, you see “cotton-wool spots” and “flame-shaped
hemorrhages” with sharp optic disc margins. This represents:
a) Hypertensive retinopathy (Grade III)
b) Diabetic retinopathy
c) Papilledema
d) Central retinal vein occlusion
